Insulet Q1 Earnings Call Highlights

Key Points

• Insulet reported Q1 revenue of $762 million (up 30% on a constant-currency basis), expanded adjusted operating margin to 17.5%, and raised full‑year 2026 revenue growth guidance to 21%–23%.
• International performance outpaced the U.S., with international Omnipod revenue up 45% CC and management forecasting mid-to-high‑20s international growth, while access wins (U.S. coverage >90%, Canadian reimbursement to 85%) are helping adoption.
• Product roadmap momentum includes near‑term integration of Omnipod 5 with FreeStyle Libre 3 Plus (addressing ~450,000 sensor users), algorithm upgrades to improve time‑in‑range, and a pivotal EVOLVE study toward a planned 2028 launch of a fully closed‑loop Type 2 system.

Insulet NASDAQ: PODD reported what executives described as a “strong start” to fiscal 2026, posting double-digit revenue growth in the first quarter while expanding operating margins and raising its full-year revenue outlook.

First-quarter results and raised full-year revenue guidance

President and CEO Ashley McEvoy said the company delivered “continued growth momentum, robust margin expansion, and disciplined execution” against the strategic priorities outlined at its Investor Day. Insulet reported 30% total revenue growth for the quarter, including 28% growth in the U.S. and 45% internationally, according to McEvoy.

Chief Financial Officer Flavia Pease provided additional detail, reporting first-quarter total revenue of $762 million, up 34% on a reported basis and 30% on a constant-currency basis. Total Omnipod revenue grew 33% on a constant-currency basis. Pease said Insulet’s global customer base grew “nearly 25%” year over year, supported by increased adoption of Omnipod 5 in both U.S. and international markets.

Based on the first-quarter performance, Insulet raised its full-year 2026 total company revenue growth guidance to 21% to 23%, up from 20% to 22%. Pease said the company now expects full-year Omnipod revenue growth of 22% to 24%. Insulet continues to project U.S. Omnipod revenue growth of 20% to 22% and increased its international Omnipod outlook to 26% to 28%.

U.S. demand, seasonality, and access initiatives

Management highlighted strong U.S. demand for Omnipod 5 across both Type 1 and Type 2, while also describing a more pronounced seasonal slowdown early in the quarter. McEvoy said the company experienced “greater than normal seasonality,” which it attributed to the annual reset of insurance deductibles that can raise patient co-pays and coinsurance.

Pease said U.S. Omnipod revenue rose 28% in the quarter and included an approximately $10 million benefit related to the timing of certain distributor orders. She said this amount is expected to be “consumed” in the second quarter and creates a roughly 200 basis point headwind to second-quarter U.S. growth guidance.

U.S. new customer starts increased year over year, but declined sequentially. Both McEvoy and Pease said they saw month-over-month improvement through the quarter and into April, which they viewed as evidence the seasonal headwind was temporary.

McEvoy also pointed to access initiatives as an important driver of Type 2 adoption. She said Insulet’s efforts to expand access and remove prior authorization requirements generated a 4% net access improvement in the first quarter, “benefiting an additional 16 million lives,” and that Insulet maintains “market-leading U.S. coverage of over 90%.”

On pricing, McEvoy said the company did not believe price pressure in the pharmacy channel contributed to first-quarter softness in new customer starts. “What we’ve been seeing as others have entered the pharmacy channel pricing and rebate behavior has been really rational and disciplined,” she said. Later in the Q&A, she added that U.S. pricing was positive in the first quarter and reiterated that the company expects pricing to be positive “over the next three years,” confirming to analysts that she was referring to net pricing.

International growth and market expansion

International results again outpaced the U.S., with Pease reporting international Omnipod revenue growth of 45% on a constant-currency basis (and 59% reported). Both she and McEvoy cited volume growth from customer expansion across markets, along with favorable price mix from ongoing conversion from Omnipod DASH to Omnipod 5.

McEvoy highlighted strong performance across established European markets including the U.K., France, and Germany, and said the U.K. delivered record new customer starts three years into the Omnipod 5 launch. She also said Insulet secured improved reimbursement and new Omnipod 5 coverage across four Canadian provinces, bringing reimbursement approval to 85% of the Canadian market.

Looking ahead, management said it remains on track to launch Omnipod 5 in Spain in the second half of 2026. McEvoy also said Insulet plans to launch FreeStyle Libre 3 Plus in Germany and Canada in the second half of the year, which the company believes will expand the population able to use Omnipod 5 in those markets.

Pease said the company expects international Omnipod revenue growth of 28% to 30% in the second quarter, with moderation reflecting comparisons to successful launches last year and a slower pace of price-mix benefit as the DASH-to-Omnipod 5 transition progresses.

Margins, operating expenses, and capital deployment

Insulet reported a first-quarter GAAP gross margin of 69.5%, which Pease said included approximately $12 million of expenses associated with a voluntary medical device correction. Adjusted gross margin was 71%, down 90 basis points year over year. Pease said adjusted gross margin was pressured by increased excess and obsolescence costs tied to transitioning to new pod configurations to support Libre 3 Plus integration and algorithm enhancements, negatively impacting adjusted gross margin by “more than 150 basis points.”

Despite higher R&D and SG&A spending, Insulet expanded first-quarter adjusted operating margin by 110 basis points to 17.5%, which Pease attributed to strong top-line growth and SG&A leverage. She said the company is stepping up R&D investment to advance its roadmap, including Omnipod 6 and a fully closed-loop system for Type 2 diabetes, and is increasing sales and marketing spending as it expands its sales force and prepares for upcoming launches.

Adjusted EPS was $1.42, up about 40% from $1.02 in the prior-year period. Pease said net interest expense was $9.8 million, higher year over year primarily due to prior debt refinancing activities and lower interest income. Insulet’s adjusted tax rate was 19.8% in the quarter.

Insulet repurchased approximately 1.25 million shares for $300 million during the quarter and ended with $480 million in cash and the full $500 million available under its credit facility. Pease reported free cash flow of approximately $90 million in the quarter.

Product roadmap, Type 2 initiatives, and quality update

Management emphasized near-term and longer-term innovation initiatives. McEvoy said Insulet expects to integrate Omnipod 5 with the FreeStyle Libre 3 Plus sensor in the current quarter, which she said could expand access to Omnipod 5 for “nearly 450,000” people currently using that sensor. She also described algorithm enhancements launching this quarter, including a new 100 mg/dL target glucose option that in simulated analysis delivered “an approximately 5% improvement in time in range,” as well as changes intended to keep users in automated mode with fewer interruptions during extended high glucose events.

On Type 2, McEvoy said the company is pursuing what it believes will be the first “truly fully closed loop system” for people with Type 2 diabetes. She pointed to feasibility data presented at ATTD showing “68% time in range with no boluses” and said Insulet enrolled its first participant in EVOLVE, a pivotal study intended to support an FDA filing next year and a planned launch in 2028.

Executives also discussed retention trends as Type 2 grows. Pease said Insulet expects U.S. retention rates to “decrease modestly” as the Type 2 customer base expands, which is why the company is investing in onboarding and engagement programs. COO Eric Benjamin added that Type 2 utilization is “pretty similar” to Type 1, while early drop-off can be higher as patients adjust to wearing the product. He also said Type 2 represented about 40% of new customer starts in the quarter.

On quality, McEvoy said the company executed a voluntary medical device correction in March and implemented targeted fixes for the applicable manufacturing process. She said Insulet does not believe the correction impacted new customer starts in the quarter. McEvoy also addressed an FDA communication update, saying it created confusion, but added that “no additional adverse events from the MDC have been reported since the April tenth update.”

About Insulet NASDAQ: PODD

Insulet Corporation is a medical device company headquartered in Acton, Massachusetts, that develops, manufactures and sells insulin-delivery systems for people with diabetes. The company's core business is the design and commercialization of its Omnipod family of tubeless, wearable insulin pumps and the consumable Pods that deliver insulin. Insulet's products aim to simplify insulin delivery for people with type 1 diabetes and insulin-requiring type 2 diabetes by offering an alternative to traditional insulin pens and tethered pump systems.

The company's product portfolio includes the Omnipod System line—disposable, waterproof Pods that adhere to the skin and deliver insulin—and the associated controllers and mobile applications used to program and monitor insulin delivery.

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